How is small bowel permeability in endometriosis patients? a case control pilot study

Abstract

Endometriosis is a chronic inflammatory disease of women of reproductive age. Small bowel (SB) permeability and lipopolysaccharides (LPS) could play a role in the perduration of low grade inflammation status and the pathogenesis of endometriosis. To clarify this hypothesis, we measured SB permeability through plasma values of LPS and urinary secretion of lactulose (La), mannitol (Ma) and their ratio (L/M) in patients with endometriosis compared with healthy controls (HC). Eight patients and 14 HC entered the study. SB permeability was evaluated by high-performance liquid chromatography of urine concentrations of La and Ma. Plasma levels of LPS were measured in the blood. Moreover, a nutritional, gastroenterological, quality of life evaluation was performed through validates questionnaires and complete gynaecological evaluations. The statistical analysis of the obtained data did not show differences in anthropometric and nutritional characteristics and gastrointestinal functional disease in the two groups. Patients reported higher levels of pelvic chronic pain (3.87 ± 2.99 vs 0.15 ± 0.55; pe = 0.001) and significantly higher LPS plasma levels (0.529 ± 0.11 vs 0.427 ± 0.08; p value = .027) than HC. Our results indicate that intestinal permeability is abnormal in endometriosis patients, and it might play a role in the pathogenesis of this chronic disease.

摘要

子宫内膜异位症是育龄妇女的一种慢性炎症性疾病。小肠(SB)通透性和脂多糖(LPS)在子宫内膜异位症的持续低度炎症状态和发病机制中可能起一定作用。为了阐明这一假说, 我们测定了子宫内膜异位症患者血浆内毒素(LPS)、尿乳果糖(La)、甘露醇(MA)及其比值(L/M)对SB通透性的影响, 并与健康对照组(HC)进行了比较。8名患者和14名HC进入研究。用高效液相色谱法测定La和MA的浓度, 评价SB的通透。测定血中内毒素(LPS)水平。此外, 通过验证性问卷和完整的妇科评估进行营养、胃肠病学、生活质量评估。对所得数据的统计分析显示, 两组在人体测量和营养特征以及胃肠功能疾病方面没有差异。患者的盆腔慢性疼痛水平(3.87±2.99vs0.15±0.55；pe＝0.001)和血浆内毒素水平(0.529±0.11vs 0.427±0.08；p值＝.027)均明显高于HC。提示子宫内膜异位症患者肠道通透性异常, 可能在此慢性病的发病机制中起一定作用。

Keywords:

• Endometriosis
• intestinal permeability
• quality of life
• chronic pain

Disclosure statement

The authors report no conflicts of interest.